Biomedical subjects

Sunil Mathur

Publications and source records attributed to Sunil Mathur.

5 recordsLinked to original sources

PubMed2006

A clinical assessment of the performance of a sensor to detect crystalline biofilm formation on indwelling bladder catheters.

OBJECTIVES: To test the ability of a sensor developed to signal infection by the organisms that generate the crystalline biofilms that encrust catheters, to give an early warning that encrustation was occurring on patients' catheters, as the care of many patients undergoing long-term bladder catheterization is complicated by the encrustation and blockage of their catheters. PATIENTS AND METHODS: Twenty patients were followed prospectively for the lifetime of one of their catheters. Sensors based on cellulose acetate/bromothymol blue were placed in the urine-collection bags, which were changed as usual at weekly intervals. The bacteriology was assessed and pH determined weekly on urine samples. Photographic records were made of the sensors twice weekly. On removal, each catheter was examined for encrustation and blockage. RESULTS: Proteus mirabilis was not isolated from five patients and in these cases the sensor colour remained golden-yellow to brown. The catheters drained for the scheduled period and showed no signs of encrustation. By contrast, the sensors turned dark blue/black in the urine of all 15 patients infected with P. mirabilis. All these patients' catheters were encrusted and in 12 the catheters blocked. The mean interval between the sensor signalling and the catheter blocking was 12 days. CONCLUSION: The cellulose acetate/bromothymol blue sensors placed in the urine collection bags are capable of signalling infection by P. mirabilis. They also signal the early stages of catheter encrustation and allow catheter replacement in ample time to avoid the clinical crises and emergency referrals caused by catheter blockage.

Biofilms↗

PubMed2006

Factors affecting crystal precipitation from urine in individuals with long-term urinary catheters colonized with urease-positive bacterial species.

Weekly urinalysis was conducted for 12 weeks on a group of 21 long-term catheter users with confirmed catheter encrustation and urinary tract colonization with urease-positive bacteria, in order to explore the cause of considerable variation in the severity of encrustation between sufferers. The rapidity of catheter blockage correlated significantly with the pH above which crystals precipitated from urine (the nucleation pH) but not the pH of the voided urine itself. Linear regression showed the nucleation pH to be significantly predicted by a combination of urinary calcium and magnesium concentrations, with calcium being the more influential variable. Reducing the rate of catheter encrustation could be achieved by lowering the urinary concentration of calcium and magnesium, which may only require catheter users to increase their fluid intake.

Calcium↗

PubMed2006

Prospective study of individuals with long-term urinary catheters colonized with Proteus species.

OBJECTIVES: To characterize the variability in the times catheters take to block with encrustation in patients who have Proteus in their urinary flora, and to identify factors responsible for modulating the rate of catheter encrustation and blockage. PATIENTS AND METHODS: Twenty patients were followed prospectively for > or = 12 weeks, with a bacteriological analysis on weekly urine samples. The pH of the voided urine samples and the pH at which crystals formed in them (the nucleation pH) were determined. Catheters were collected and examined for bacterial biofilm and crystal deposition. RESULTS: The time that catheters took to block was 2-98 days. The mean pH of the urine voided by patients designated as slow encrusters (6.9) was not significantly different (P = 0.237) from that of rapid encrusters (7.2). However, patients whose catheters took longer to block had a significantly higher mean nucleation pH (8.1 vs 7.3, P = 0.002) and significantly higher mean safety margin between their nucleation pH and voided pH (1.17 pH units vs 0.13, P = 0.003). CONCLUSION: The variation in the rate of catheter encrustation between individuals infected with Proteus is a function of the difference between the voided pH and the nucleation pH of their urine. The value of nucleation pH of an individual's urine varies widely, suggesting it should be possible to devise strategies to increase this value and thus reduce the rate of encrustation in those with urinary tract colonization by urease-positive bacteria.

Biofilms↗

PubMed2005

A robust statistical method for detecting differentially expressed genes.

DNA microarray technology allows researchers to monitor the expressions of thousands of genes under different conditions, and to measure the levels of thousands of different DNA molecules at a given point in the life of an organism, tissue or cell. A wide variety of different diseases that are characterised by unregulated gene expression, DNA replication, cell division and cell death, can be detected early using microarrays. One of the major objectives of microarray experiments is to identify differentially expressed genes under various conditions. The detection of differential gene expression under two different conditions is very important in biological studies, and allows us to identify experimental variables that affect different biological processes. Most of the tests available in the literature are based on the assumption of normal distribution. However, the assumption of normality may not be true in real-life data, particularly with respect to microarray data.A test is proposed for the identification of differentially expressed genes in replicated microarray experiments conducted under two different conditions. The proposed test does not assume the distribution of the parent population; thus, the proposed test is strictly nonparametric in nature. We calculate the p-value and the asymptotic power function of the proposed test statistic. The proposed test statistic is compared with some of its competitors under normal, gamma and exponential population setup using the Monte Carlo simulation technique. The application of the proposed test statistic is presented using microarray data. The proposed test is robust and highly efficient when populations are non-normal.

Journal Article↗

PubMedDate not supplied

Limitations of urinary pH monitoring in long-term catheter users.

Weekly measurement of urinary pH has become a standard part of long-term catheter management in many parts of the UK. The common problem of catheter encrustation is caused by urease-producing bacteria which also tend to produce alkaline urine. To determine if urinary pH changes in individual catheter users provided enough information for pH monitoring to aid in catheter management, an analysis of the literature was combined with a study of the urinary pH and catheter blockage patterns in 20 catheter users colonized with urease-producing bacteria. It was found that weekly pH measurement does not aid in the diagnosis or management of catheter encrustation. As such, this practice cannot be recommended.

Bacterial Infections↗